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General NPI Number Information
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NPI Number | 1104974252
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Entity Type | Individual
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Provider Name | LORNA JANE LICSW
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 5203 CENTER BLVD APT 2706
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-6672
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Country | US
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Telephone | 173-653-8376
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Fax | 187-868-7147
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Provider Business Mailing Address
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Address Line | 5203 CENTER BLVD APT 2706
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-6672
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Country | US
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Telephone | 617-365-3757
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Fax | 718-786-8714
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 094621
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1032141
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC22356
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License Number State | ME
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